肺癌化疗患者PICC置管与静脉血栓栓塞症的研究进展

发布时间：2018-05-08 11:24

本文选题：肺癌 + 化疗　；参考：《重庆医科大学》2017年硕士论文

【摘要】：2008年世界卫生组织(WHO)公布的数据表明,肺癌的年发病率和年死亡率均处于全球癌症之首,肺癌也是我国癌症的首要死亡原因。大多数肺癌发现时已处于中晚期,失去手术切除机会,化疗成为主要的治疗方法,常经外周静脉置入中心静脉导管(Peripherally Inserted Central Catheter,PICC)建立静脉通道来完成化疗药物的输注。PICC是将导管由外周静脉插入,沿着血管走向最后到达上腔静脉的下1/3段或者右心房和上腔静脉相连的地方,其损伤小,保护血管和组织,适合于需输入刺激性强的药物、长期静脉输液、反复输血等情况的患者,但PICC置管可引发相关并发症,尤其是形成静脉血栓栓塞症。静脉血栓栓塞症(Venous Thromboembolism,VTE)包括肺血栓栓塞症(Pulmonary Thromboembolism,PTE)和深静脉血栓形成(Deep Venous Thrombosis,DVT),也是肺癌的严重并发症。文献报道,肿瘤患者VTE发生率为4%-20%,Kadlec B等[1]进行队列研究发现,肺癌患者VTE的发生率高达8.4%。黄家香等[2]报道,相比健康人群,癌症患者VTE的发生风险高4倍,化疗后VTE的风险将升高至6.5倍。综上,肺癌患者经PICC置管化疗后VTE的发生率将进一步升高。为提高医护人员对VTE的认识,本文就肺癌化疗患者PICC置管发生VTE的危险因素、风险评估方法、预防措施的研究进展进行综述,以期更好地预防和减少VTE发生,减少VTE患者死亡率。
[Abstract]:The data released by World Health Organization (WHO) in 2008 show that the annual morbidity and mortality of lung cancer are the first in the world, and lung cancer is also the leading cause of death of cancer in China. Most lung cancer is found in the middle and late stage, lost the opportunity of surgical resection, chemotherapy as the main treatment, Peripheral Inserted Central catheterization is often placed through peripheral veins to establish venous channels to complete the infusion of chemotherapeutic drugs. PICC is to insert the catheter from the peripheral vein. Following the direction of the vessel to the bottom third of the superior vena cava or where the right atrium is connected to the superior vena cava, it has little damage, protects the blood vessels and tissues, and is suitable for the use of highly irritating drugs for long-term intravenous infusion. In patients with recurrent blood transfusions, however, PICC catheterization can lead to complications, especially venous thromboembolism. Venous Thromboembolism (VTEs), including pulmonary thromboembolism (PTEs) and deep Venous thrombosis (DVT), is also a serious complication of lung cancer. It is reported that the incidence of VTE in cancer patients is 4- 20% Kadlec B et al. [1] Cohort study found that the incidence of VTE in lung cancer patients is as high as 8.4%. Huang Jiaxiang et al reported that the risk of VTE in cancer patients was four times higher than that in healthy people, and the risk of VTE increased to 6.5 times after chemotherapy. In conclusion, the incidence of VTE in patients with lung cancer after chemotherapy with PICC catheter will be further increased. In order to improve the medical staff's understanding of VTE, this article reviews the risk factors, risk assessment methods and preventive measures of VTE in patients with lung cancer treated with PICC in order to better prevent and reduce the occurrence of VTE. Reduce mortality in patients with VTE.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R734.2

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